PROJECT SUMMARY Recognition that adolescents are a reservoir for several vaccine preventable diseases has led to a number of new vaccine recommendations specifically targeted to this population. However, implementation of the adolescent platform of vaccines, which includes the tetanus-diphtheria-acellular pertussis (Tdap), meningococcal conjugate (MCV4), human papillomavirus (HPV4) vaccines (for females) has thus far been substantially below national vaccine coverage goals. There is a paucity of data regarding effective interventions for improving vaccination coverage within the adolescent population. Our broad, long term research objective therefore is to develop and evaluate interventions to improve uptake of vaccines by this population. Patient, parent and provider barriers to, and facilitators of, adolescent vaccination are not well understood. The objectives of this proposal are to conduct formative research so as to better understand these factors, and then use this information to develop, implement and assess a multi-component intervention to improve adolescent vaccine uptake. At a minimum, the intervention will include 1) reminder/recall systems to alert parents and providers about when vaccine doses are needed, and 2) a tailored educational web-based tool to modify negative parental attitudes about adolescent vaccines. These two issues are believed to be major barriers to improving adolescent vaccine utilization. The four Aims of this proposal are: 1) To determine the baseline utilization levels of, and the clinical and personal characteristics associated with, vaccine utilization for the adolescent platform of vaccines among a defined population in Michigan; 2) To assess the patient, parent and provider barriers that currently hinder adolescent vaccine utilization in this population; 3) To develop, implement, and assess a multi-component intervention to improve adolescent vaccination rates within this population; and 4) To develop an adolescent vaccination toolkit that is based on lessons learned from our intervention. Impact: The expected outcome of our proposal is the development of a multi-component intervention that is effective at increasing adolescent vaccine utilization, and a provider toolkit that can be used to implement these interventions elsewhere. Because we intend to develop interventions that could be feasibly implemented in a variety of settings, our intervention could have a significant impact because it would be easily scaleable to broader and larger populations to improve adolescent vaccination rates.